Endocrine Connections最新文献

{"title":"Quality of life and psychological status in people with acromegaly in relation to facial changes.","authors":"Maria Antonia Martínez-Momblán, Sergio Alonso-Fernández, Montserrat Marques-Pamies, Isabel Salinas, Federico Vázquez, Berta Soldevila, Diego Asensio-Wandosell, Raquel Ciriza, Alicia Santos, Elena Valassi, Susan M Webb, Manuel Puig-Domingo","doi":"10.1530/EC-24-0545","DOIUrl":"10.1530/EC-24-0545","url":null,"abstract":"<p><strong>Introduction: </strong>The diagnosis of acromegaly is often delayed, leading to facial disfigurements that persist despite endocrine cure. We aimed to study the relationship between facial modifications, Quality of Life (QoL), and psychologic status in patients with acromegaly.</p><p><strong>Methods: </strong>Sixty-five patients in remission or with hormonal disease control participated (29 women and 36 men; mean age 57.4±13.5 years). The following variables were assessed: a) Quality of life using AcroQoL; b) Anxiety level with the STAI Questionnaire; c) Self-esteem by the Rosemberg Scale; and d) Facial acromegaly phenotypic changes evaluated from photographs by 8 experienced endocrinologists using a Likert scale.</p><p><strong>Results: </strong>The overall AcroQoL score showed mid-range values, with better scores for men (72.3 vs 56.6, p=0.022). AcroQoL physical domain was also higher for men (59.0 vs 34.9, p=0.006). In the psychological domain, men tended to score better (65.7 vs 54.5, p=0.069), particularly in the appearance subdimension (53.8 vs 38.8, p=0.07), while women had worse anxiety scores (p=0.009). Global self-esteem was high (2.7 ± 0.6 for a maximal value of 3), without sex differences. A trend towards a negative correlation between self-esteem and facial scores was observed (rs= -0.559, p=0.074), indicating a low psychological impact.</p><p><strong>Conclusion: </strong>In controlled acromegaly, QoL is relatively preserved in both genders, although men have better anxiety scores. Facial changes have a weak but persistent negative impact on psychological status, with greater intensity observed in women.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral blood HIF-1α levels: a study on their predictive ability for early-stage diabetic retinopathy.","authors":"Zhiqiang Su, Lijuan Chen, Meijuan Lu, Jingyi Li, Liping Qiu, Liting Shi","doi":"10.1530/EC-25-0004","DOIUrl":"https://doi.org/10.1530/EC-25-0004","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to investigate the correlation between the levels of hypoxia-inducible factor-1α (HIF-1α) in the peripheral blood of patients with type 2 diabetes (T2D) and early-stage diabetic retinopathy (DR) and to evaluate its potential as a predictor of early DR.</p><p><strong>Methods: </strong>From November 2021 to December 2023, 70 patients who underwent fundus photography at Zhangzhou Second Hospital were recruited. Based on the results, patients were categorized into a T2D group comprising 25 patients and a DR group comprising 45 patients. In addition, 18 healthy individuals who underwent routine physical examinations during the same period were included as a control group. Serum levels of the HIF-1α protein were measured in all three groups.</p><p><strong>Results: </strong>The results indicated that patients in the early-stage DR group had significantly higher levels of HIF-1α, albumin (Alb), Ca and blood urea nitrogen (BUN) compared to the T2D group (P < 0.05). In addition, patients in the DR group exhibited higher levels of total cholesterol, high-density lipoprotein cholesterol (HDL-C), fasting plasma glucose (FPG) and glycated hemoglobin (HbA1C) than the control group (P < 0.05). The incidence rates of DR in groups A, B, C and D were 18.18, 31.82, 59.09 and 95.45%, respectively, with statistically significant differences (P < 0.05). Spearman's correlation analysis revealed significant positive correlations between HIF-1α and age, disease duration (years), systolic blood pressure, Cr, FPG and HbA1c, with a strong positive correlation between HIF-1α and HbA1c (P < 0.05) optimal cutoff value of 2.3855 ng/mL.</p><p><strong>Conclusion: </strong>Increased levels of HIF-1α in peripheral blood are closely linked to the development of DR, suggesting that HIF-1α may act as a potential biomarker for the early detection and prediction of DR risk.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":"14 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inhibition of microRNA-139-5p by glucagon-like peptide-1 ameliorates oxidative stress-induced vascular endothelial cell damage via targeting SOD1/GCLc.","authors":"Jiaqi Zhang, Jiake Mo, Ying Liu, Xubiao Meng, Weian Tang, Lanfang Fu, Jing Xiong, Zhaohui Mo","doi":"10.1530/EC-25-0022","DOIUrl":"https://doi.org/10.1530/EC-25-0022","url":null,"abstract":"<p><strong>Graphical abstract: </strong></p><p><strong>Abstract: </strong>Oxidative stress is a key driving factor for the progression of vascular disease in diabetes, and is closely related to endothelial dysfunction. The exact mechanism by which glucagon-like peptide-1 (GLP-1) directly protects vascular endothelium by reducing oxidative stress is not yet fully understood. In this study, we investigated the protective effect of GLP-1 on endothelial cells exposed to palmitic acid (PA)/high glucose-induced oxidative stress and further explored the potential mechanisms involved in microRNA-139-5p (miR-139-5p) regulation. We found that miR-139-5p expression was exhibited significantly elevated in HUVECs that were exposed to PA/high glucose or H2O2, which were reversed by glutathione. Interestingly, this expression was significantly attenuated after GLP-1 pretreatment, with reduced reactive oxygen species (ROS), increased GSH/GSSG ratio and amelioration of cell dysfunction. Overexpression of miR-139-5p resulted in increased ROS and apoptosis, decreased GSH/GSSG ratio, damaged migration and proliferation of HUVECs, while inhibition of miR-139-5p significantly restored PA-induced HUVECs impairments. Further investigation revealed that miR-139-5p directly targets superoxide dismutase 1 (SOD1)/glutamate-cysteine ligase catalytic (GCLc) subunit. The upregulation of miR-139-5p abrogated the protective effects of GLP-1 on cells exposed to PA, and GLP-1-induced downregulation of miR-139-5p was counteracted by the GLP-1 receptor antagonist exendin(9-39). These findings demonstrated that GLP-1 ameliorates oxidative stress-induced endothelial dysfunction, at least in part, by suppressing miR-139-5p, which targets SOD1 and GCLc. This provides further evidence for the vascular protective effects of GLP-1 intervention in diabetes.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":"14 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing self-management of adrenal crisis in patients with adrenal insufficiency: a qualitative study.","authors":"Aldons Chua, Heather Yoeli, David Till, Umesh Dashora, Patrick Oyibo, William M Drake, Martin Cartwright, Sofia Llahana","doi":"10.1530/EC-24-0651","DOIUrl":"https://doi.org/10.1530/EC-24-0651","url":null,"abstract":"<p><strong>Objective: </strong>Adrenal crisis is a life-threatening complication that requires urgent administration of parenteral hydrocortisone. Current patient education interventions remain ineffective, contributing to preventable hospitalisations and deaths. This study explored the lived experiences of individuals with adrenal insufficiency, focussing on the factors influencing self-management during adrenal crises.</p><p><strong>Methods: </strong>This qualitative study employed online semi-structured interviews with adults with adrenal insufficiency who had experienced at least one adrenal crisis in the past 3 years. Participants were recruited via patient advocacy groups in the United Kingdom. Data were analysed using an inductive thematic approach, allowing themes to emerge directly from the data without imposing predetermined categories.</p><p><strong>Results: </strong>Twelve themes, grouped into four overarching domains, captured individual experiences of managing adrenal crises: i) knowledge and experience; ii) tools and training; iii) psychological and emotional impact; and iv) support and dependence on others. Participants reported challenges including delayed diagnosis, difficulties recognising adrenal crisis symptoms and the complexity of the hydrocortisone injection process. However, prior experiences of adrenal crises, patient education and advocacy resources fostered greater confidence in self-management. Participants highlighted the need for simplified injection devices, clearer stress dosing guidelines, improved training for healthcare professionals and increased public awareness.</p><p><strong>Conclusion: </strong>Findings from this qualitative study emphasise that effective adrenal crisis management requires patient-centred, evidence-based interventions focussing on education, healthcare professional training and public awareness. Simplified hydrocortisone delivery devices and systemic reforms are crucial to supporting self-management and minimising preventable hospitalisations and fatalities caused by adrenal crises.</p><p><strong>Plain language summary: </strong>People with adrenal insufficiency face life-threatening emergencies called adrenal crises, which need urgent treatment with hydrocortisone injections. In this study, 12 people shared their struggles, including complex injection procedures, severe symptoms which made self-injection challenging and limited support to manage these crises effectively. Simpler injection devices, better information and improved training for healthcare staff could help people self-manage their condition better, prevent avoidable hospital admissions and save lives.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":"14 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased risk of multisystem comorbidities and disease trajectories following hyperthyroidism: evidence from the 0.5 million UK Biobank population.","authors":"Qiuyuan Chen, Doudou Chen, Xinpan Wang, Yunhao Zheng, Longyao Zhang, Zaiming Li, Xiaoyu Wu, Qin Chen, Ruyang Zhang, Feng Chen, Tao Yang, Xuqin Zheng, Yongyue Wei","doi":"10.1530/EC-25-0066","DOIUrl":"10.1530/EC-25-0066","url":null,"abstract":"<p><strong>Background and aims: </strong>Hyperthyroidism is a clinical syndrome caused by the excessive production of thyroid hormones, which can have a broad impact on overall health. We systematically investigated the subsequent multisystem comorbidities associated with hyperthyroidism and the progression of these conditions.</p><p><strong>Methods: </strong>After a 1:4 propensity score matching, a total of 5,832 hyperthyroidism patients and 22,579 controls from the UK Biobank were included in this study. Phenome-wide association study was conducted to explore the associations between hyperthyroidism and a broad range of subsequent diseases, supplemented by landmark analysis to depict the time-varying effects. Disease trajectory analysis was used to explore the sequential pattern of comorbidity progression of hyperthyroidism.</p><p><strong>Results: </strong>Patients with prior diagnosed hyperthyroidism were observed to have an elevated risk of developing 110 subsequent diseases across multiple systems and all-cause mortality and four causes of death, with particularly marked short-term adverse effects. Disease trajectory analysis demonstrated that the three disease clusters most affected by hyperthyroidism were cardiovascular disease cluster, gastrointestinal inflammatory disease cluster and diabetes-mediated disease cluster.</p><p><strong>Conclusion: </strong>Hyperthyroidism is associated with an elevated risk of subsequent multisystem diseases and mortality. Disease trajectory analysis has elucidated critical sequential patterns of disease progression, offering valuable insights for the management of comorbidities in patients with hyperthyroidism.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of tryptophan metabolism-related biomarkers for nonalcoholic fatty liver disease through network analysis.","authors":"Cuihua Jiang, Jianqi Liang, Kaibo Hu, Yanqing Ye, Jiajia Yang, Xiaozhi Zhang, Guilin Ye, Jing Zhang, Deju Zhang, Bin Zhong, Peng Yu, Liefeng Wang, Bin Zeng","doi":"10.1530/EC-24-0470","DOIUrl":"10.1530/EC-24-0470","url":null,"abstract":"<p><strong>Background: </strong>Increasing evidence demonstrates that tryptophan metabolism is closely related to the development of nonalcoholic fatty liver disease (NAFLD). This study aimed to identify specific biomarkers of NAFLD associated with tryptophan metabolism and research its functional mechanism.</p><p><strong>Methods: </strong>We downloaded NAFLD RNA-sequencing data from GSE89632 and GSE24807, and obtained tryptophan metabolism-related genes (TMRGs) from the MsigDB database. The R package limma and WGCNA were used to identify TMRGs-DEGs, and GO, KEGG and Cytoscape were used to analyze and visualize the data. Immune cell infiltration analysis was used to explore the immune mechanism of NAFLD and the biomarkers. We also validated extended levels of biomarkers.</p><p><strong>Results: </strong>We identified 375 NAFLD differentially expressed genes (DEGs) and 85 TMRGs-DEGs. GO/KEGG analysis revealed that TMRGs-DEGs were mainly enriched in triglyceride and cholesterol metabolism. ROC curves identified CCL20 (AUC = 0.917), CD160 (AUC = 0.933) and CYP7A1 (AUC = 1) as biomarkers of NAFLD. Immune infiltration analysis showed significant differences in ten immune cells, and the activation of dendritic cells and mast cells were highly positively correlated with NAFLD. CCL20, CD160 and CYP7A1 were highly correlated with M2 macrophage, neutrophil and mast cells activation, respectively. Twenty-seven TMRGs correlated with hub genes, and gene set enrichment analysis demonstrated their function in tryptophan- and lysine-containing metabolic process. We identified 41 therapeutic drug matches which corresponded to two hub genes and four drugs which co-targeted CCL20 and CYP7A1. Finally, three hub genes were validated in our mouse model.</p><p><strong>Conclusions: </strong>CCL20, CD160 and CYP7A1 are tryptophan metabolism-related biomarkers of NAFLD, related to glycerol ester and cholesterol metabolism. We screened four compounds which co-target CCL29 and CYP7A1 to provide potential experimental drugs for NAFLD.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimation of kidney function in Graves' disease using creatinine and cystatin C.","authors":"Sorena Abbaszadeh, Martin H Lundqvist, Östen Ljunggren, Anders Olof Larsson, Maria K Svensson, Selwan Khamisi","doi":"10.1530/EC-24-0698","DOIUrl":"10.1530/EC-24-0698","url":null,"abstract":"<p><strong>Introduction: </strong>There is no consensus regarding methods to estimate kidney function in hyperthyroidism. The aim was therefore to assess changes in filtration markers in patients with Graves' disease undergoing treatment with antithyroid drugs.</p><p><strong>Methods: </strong>Thirty patients with de novo Graves' disease were included. Blood sampling, including thyroid-stimulating hormone, fT3, fT4 and creatinine, was performed at baseline, 6 weeks, 3, 6, 12 and 24 months. Cystatin C was measured from frozen samples. To calculate creatinine- and cystatin C-based eGFR, the Lund-Malmö equation (LMR) and the CAPA formula were used.</p><p><strong>Results: </strong>fT3 and fT4 normalized during treatment. Creatinine increased initially but stabilized after 6 months. eGFRLMR decreased until 12 months. Cystatin C decreased, while eGFRCAPA and eGFRCAPA/eGFRLMR increased until 6 months. The mean of eGFRLMR and eGFRCAPA remained stable. The % changes in creatinine and cystatin C were associated with % changes in fT3 and fT4. In regression models including fT3 or fT4 with body weight (all % change), fT3 and fT4 were the strongest predictors of percentual changes in both creatinine and cystatin C.</p><p><strong>Conclusion: </strong>The increase in creatinine and decrease in cystatin C during the treatment of Graves' disease was significantly associated with changes in thyroid hormones, and for creatinine, also body weight. The mean of eGFRLMR and eGFRCAPA remained stable, suggesting that creatinine and cystatin C were affected by different non-GFR-related factors. The potential use of eGFRLMR and eGFRCAPA to assess kidney function in patients with thyroid disorders should be further evaluated in studies measuring kidney function with state-of-the-art methods.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PERSPECTIVE: Challenging preoperative α-blockade in phaeochromocytoma surgery: beyond tradition, towards 'safer surgery'.","authors":"Isabelle Holscher, Koen M A Dreijerink, Markus W Hollmann, Tijs J van den Berg, Wouter D Lubbers, Anton F Engelsman, Els J M Nieveen van Dijkum","doi":"10.1530/EC-25-0139","DOIUrl":"10.1530/EC-25-0139","url":null,"abstract":"<p><p>The rarity of phaeochromocytomas has left a gap in evidence supporting guideline recommendations for preoperative α-blockade dose-escalation. Despite recent studies questioning its efficacy, randomized-controlled trials (RCTs) are warranted before considering omitting preoperative α-blockade dose-escalation. Through an online survey, opinions on the ideal study design for this future RCT were gathered from specialists involved in phaeochromocytoma management in the Netherlands. Responses from 23 physicians suggest a non-inferiority-designed RCT that only excludes patients with severe comorbidities and incorporates clinical outcome measures as most suitable design. The survey furthermore revealed diverse opinions regarding study design and perioperative threats, emphasizing the importance of an inclusive, multidisciplinary approach in future research.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"German DVO risk score identified more patients requiring treatment compared to FRAX.","authors":"Anna Frank, Judith Charlotte Witzel, Christina Heppner, Annette Lamersdorf, Andreas Leha, Heide Siggelkow","doi":"10.1530/EC-25-0048","DOIUrl":"10.1530/EC-25-0048","url":null,"abstract":"<p><strong>Purpose: </strong>Fracture risk determination is essential when recommending treatment in osteoporosis management. We calculated the risk probabilities of major osteoporotic and hip fractures using the DVO score established in German-speaking countries and the FRAX tool.</p><p><strong>Methods: </strong>We retrospectively analysed data from 555 female patients (mean age 64.2 ± 10.3 years) evaluated for osteoporosis. As suggested by DVO guidelines before 2023, we set the therapy threshold of >30% for vertebral and hip fractures. Major osteoporotic fracture (MOF) and hip fracture risk (HF) were calculated based on corresponding FRAX scores. We applied the internationally most common therapy threshold of ≥20% for MOF and ≥3% for HF and determined the 'DVO-equivalent risk levels' for FRAX-based assessment.</p><p><strong>Results: </strong>The DVO score identified 52.8% of women as having a 10-year risk of hip and vertebral fractures >30%. FRAX score for HF ≥ 3% without bone mineral density (BMD) identified the highest number of patients (56%). The proportion of female patients identified for treatment only by DVO score (14.6%) were more likely to present spinal fractures (38.3 vs 18.6%), whereas the 10.6% of patients only identified by FRAX including BMD presented more peripheral fractures (40.7 vs 29.6%). The thresholds for this 'DVO-equivalent risk level' for 'FRAX with BMD' would be ≥10% for MOF and ≥2.6% for HF.</p><p><strong>Conclusion: </strong>Given the differences in the DVO and FRAX scores, we highly recommend considering both scores when assessing individual women for treatment.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is subclinical hypothyroidism associated with cardiovascular disease in the elderly?","authors":"Koichiro Yamamoto, Yasuhiro Nakano, Yoshiaki Soejima, Atsuhito Suyama, Kohei Oguni, Kou Hasegawa, Fumio Otsuka","doi":"10.1530/EC-24-0601","DOIUrl":"10.1530/EC-24-0601","url":null,"abstract":"<p><p>Subclinical hypothyroidism (SCH) is diagnosed when thyroid function tests show that the serum thyrotropin (TSH) level is elevated and the serum free thyroxine (FT4) level is normal. SCH is mainly caused by Hashimoto's thyroiditis, the prevalence of which increases with aging. Recently, it has been revealed that SCH is associated with risk factors for cardiovascular diseases (CVDs), including atherosclerosis, dyslipidemia and hypertension, leading to cardiovascular morbidity and mortality. However, there are still controversies regarding the diagnosis and treatment of SCH in elderly patients. In this review, we present recent evidence regarding the relationship between SCH and CVD and treatment recommendations for SCH, especially in elderly patients. Studies have shown that SCH is associated with CVD and all-cause mortality. Patients aged less than 65 years showed significant associations of SCH with CVD risk and all-cause mortality, whereas patients aged 65 or older did not show such associations. It was shown that levothyroxine therapy was associated with lower all-cause mortality and cardiovascular mortality in younger SCH patients (<65-70 years) but not in SCH patients aged 65-70 years or older. In elderly SCH patients, levothyroxine treatment should be considered individually according to the patient's age, serum TSH level, hypothyroid symptoms, CVD risk and other comorbidities. To further elucidate the impact of SCH on CVD in elderly patients, studies should be conducted using age-specific reference ranges of results of thyroid function tests, focusing on elderly patients, specific serum TSH levels, thyroid antibody status and cardiovascular risk factors.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}